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SPECIA� TY ELECTRONIC SYSTEMS �N�. 018362 <br /> CITY OF ZEPHYRHILLS/ PERMITS 4/6/2011 <br /> 25 00 <br /> Wachovia 25 00 <br /> s� �-�ao-oazo City of Zephyrhills'Fir$ Fax-813-780-0021 <br /> Permit Application <br /> late Received - Phone Contact far Pertnit <br /> ;�s!:��e.:�c�e�. .z. aa� �..w.,.y.�......�:.�.�,...�..�....�.-a,�� <br /> 3wners Nama � \ Y1 �' S � � pwner's Phone Number �� �� , ` <br /> �nme�s Address � �� ( � <br /> �ee Simple Titlehoider Name Tttleholder Pfione IVumber �� �l <br /> =ea Simple Titlehoider Address <br /> Job Address Lat # C <br /> Sub Division Parcel # �'� � a.t(j - ,�/ ' (��� � ' � � V 1� -�d <br /> ��ns.���xc��� s�a� <br /> � Bto-Hazard Waste 5iarage - ANNIlAL � Fumigatlon Tent <br /> � Comm Exhaust f�tchen HoodlDoct � Haza►dous MateAal (Tier li ar RQ Facflity) ANNUAL <br /> a ConVollsd Bum � Hood Installation <br /> � Emergency Generator < 30 kw � LP/NaWraf Gas-InstailaBon �� ` <br /> Emergency Generator> 30 kw � LP/Natural Gas-ANNUAL Sale ,i j <br /> Flre ProteoBon Mairtenance -ANNUAL � Places of Assembly-ANNUAL � ���� <br /> r y emi � er � <br /> Sprinkler �❑ ❑ O� a Recreadonal Bum I <br /> Fire Alarm � <br /> O ❑ � � � Sparklers <br /> Haod Cleaning O O ❑ C� � Sprinkler System Instellations <br /> Hood Suppression � ❑ ❑ ❑ �� � Standpipes (SprinWer Sys) - <br /> a Firo Alartn Instaitation � Toroh.Roofing/TarKettle <br /> Fire Pumps � Waate Tire Storage ANNUAL <br /> Fire Wotks • <br /> Flammable Applicatlon-ANNUAL ValuaUon of Project <br /> Fuel Tanks <br /> Q Other. <br /> Contractor Comparry '� .G '�� C, <br /> Signature ' Registerail Y N Fee Cucrent N <br /> Addrass l � License # D� 1� <br /> ELECTRICiAN Company <br /> 5lgnature Regfstered Y/ N Fee Current Y I N <br /> Add2ss License # <br /> PLUMBER Company <br /> Signature Registered Y/ N Fea Curtent Y/ N <br /> Address Licensa # <br /> MECHANICAL Company <br /> Signature Registered Y/ N Fee Curtent Y/ N <br /> Address License # <br /> OTHER Company <br /> Slgnature <br /> Registered Y/ N Fee Curtent Y i N� <br /> Address <br /> �,,,� �,�,_,,,, �_ _ Ucense # <br /> �irections: <br /> Fll out appi3cation completely. <br /> Owner 8 Contractor sign bsck of applicadon, notarized (Or, copy of signad conbact with owner) <br /> If over 52500, a Notice of Commencement is required (Mechanicak work over 35000) <br /> Suppiy two (2) sets of drawings with appiicable documerda8on � <br /> Allaw 10-14 days tor ravfew aiter submittal date. Parcal #- abtained irort{ Property Tax NoUce (http:/lappraiser.pascogov.com) <br />